Melanoma: Prevention, Detection, and Treatment

WebMD Live Events Transcript

When is a mole a problem? What do melanomas look like? Are tanning salons OK? How can melanoma be prevented? With the increased incidence of melanoma (up 2000% since 1930), you need to know the answers to these questions and more.DuPont Guerry, MD, joined us for a closer look at prevention, detection, and treatment of melanomas on June 22, 2005.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Welcome to WebMD Live, Dr. Guerry. Thank you for joining us today. The increase in the incidence of melanoma is startling -- 2000% since 1930. To what do you attribute this increase?

I suspect it's a combination of more people getting more sun, particularly 20 or 30 years ago, because you pay now for the sun that you got in the past. So much of it is due to what we know to be the major cause of melanoma, that is, sun exposure, particularly on white skin that has not been previously exposed to sun. So it's likely big blasts of sunlight in childhood that increases the risk of melanoma later in life. That's not to say it's not the sun you got five or 10 years ago, that also makes a contribution.

Another piece of this may be that we are better at recognizing melanomas, so some of the increase is because we have found early melanomas that we used to ignore.

If we were exposed as children 20, 30, 40 years ago, is there anything we can do now to prevent melanoma?

"The thing to do as an individual is to look at your skin from top to bottom, often with the aid of a friend, companion, partner, spouse, interested individual, once a month, looking for things that are different, odd or changing."

Sure. Although things may have been set in motion 20, 30 or 40 years ago, the train goes faster if you add more fuel, so continuing to moderate sun exposure will likely decrease the likelihood of getting melanoma. So it isn't all what you got back in childhood.

Another piece of the puzzle is learn to examine your own skin for suspicious changing spots that are often pigmented, dark brown, dark, dark like black, that sort of thing. You want to find your melanoma before it has any capacity to do you in. And one of the nice things, and I mean nice, about melanoma is it is pigmented in the skin, there for you to look at, there for you to recognize as alien and changing and there for you to take to your doctor and have it taken care of before it can do something bad to you. Early melanoma is generally easy to recognize and highly curable.

What should we be looking for? And where on the body should we be looking?

Traditionally melanomas appear where you have had plenty of sun, and so a favorite place is on the back of both men and women, on the particularly lower extremities of women, but in fact there is no place, base, anterior trunk, abdomen, that is immune to melanoma.

The thing to do as an individual is to look at your skin from top to bottom, often with the aid of a friend, companion, partner, spouse, interested individual, once a month, looking for things that are different, odd or changing.

There are these things called the A, B, C, D, Es of melanoma, so what you're looking for is:

  • Something A, asymmetrical . If you were to put a line through the middle of it and then fold it over on itself it wouldn't match up, that's asymmetry.
  • B is for border irregularity . If you look at where this spot ends, it's sort of a jagged line around the outside as opposed to smooth round thing or oval.
  • C is color , and you look for blue black, black, brown -- different hues of brown and black.
  • D is diameter . We talk about a mole or pigmented spot that is bigger than 6 millimeters across, a little bigger than the eraser of a number 2 pencil. That's a spot to pay some attention to.
  • Then a lot of attention has been played to E for evolution -- change or something new. So in particular, a spot which used to be two millimeters and is now six millimeters; a spot that was not present previously and is now there and a month or two has passed and it's still there and bigger. That sort of change, new thing, should be investigated, generally by seeing your primary care doctor or dermatologist.

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